Cavenous Malformation

Question 1

AKA cavernous malformation

Answer 1

AKA: cavernous hemangioma, cavernoma, cavernous angioma, angioma, hemangioma,

Question 2

DX

Answer 2

MRI 2 + SWI / GRE popcorn 🍿 apreance ➡️➡️ Pathonemonic
MRI c r/o DVA , cpillary telangictisa
Angio CM usually occult 🚫 unless to R/ o AVM
Spine In the absence of spine symptoms, routine imaging of the spine is not indicated in patients with cerebral CMs.31

Question 3

Flow cavernoma

Answer 3

Low
Without brain 🧠 pranchyam🔛 HHT

Question 4

Pathology

Answer 4

Defect endothelia junction , absence of muscular layer

Question 5

📍 location

Answer 5

80 % supratentorial ➡️followed by. Brain stem ( pons)🆙▶️ multiple

Question 6

RF cavernoam

Answer 6

Radiation

Question 7

Genetic carvnouma

Answer 7

Question 8

Sx k

Answer 8

Seizure
Hemorrhage
Ficalmdefictn

Question 9

Presentation

Answer 9

Seizure > hemorrhage

Question 10

Factor ⏏️ bleed 🩸

Answer 10

Initially present with hemorrhage
Brainstem CM
Extralesional
Age < 30
Deep location
Size > 1 cm
Female
Pregnancy 🤰🏼
Prior bleed

Question 11

Annular risk of recent bleeding

Answer 11

Sparodic 2,5 y vs familial 4-6 %
Spine 2%

Question 12

Zabramski classification of cavernous malformation

Answer 12

MCC type 2

Question 13

Sscreening

Answer 13

1 st degree relative + one family memebrer with CM ➡️ indicate MRI screening + genetic counseling

Question 14

TX surgical indications

Answer 14

Asymptomatic ➡️solitary , non eloquent ➡️aim ⬇️ bleed, psychological, follow up , lifestyle, resume anticoagulant
Symptomatic ;
< 6 was if w/ seizure related to the lesion and refractory
M&M = 1-2 y after 1 st bleeding
⭐️ 2nd 🥈 symptomatic bleeding brainstem

Deep with symptom as or previous hemorrhage M&M = 5-10 yes after 1st 🩸
Weak indication➡️ sin
Emdisbaling bleeding from brainsteam

Question 15

Radiotsurgery CM

Answer 15

Deep and eloquent, wi hemorrhage

Question 16

Follow up Cm

Answer 16

Asymptomatic, incidentally 2-3 y to r/o sub clinical bleedign
Post op 3 month

Question 17

Poor outcome

Answer 17

Brainsteam CM b.EVD and approach through floor of the 4th
Deep BG , thalamus

Question 18

Cavernoma variants .

Answer 18

Hemangioma calcificans variant s variant of cavernoma occurs more in the temporal lobe